Will Running the Numbers First Violate the Principles of Patient-Centered Care?
Authors: Sam F. Carter
Journal: Annals of Internal Medicine (2008)

Letters2 December 2008Will Running the Numbers First Violate the Principles of Patient-Centered Care?Sam F. Carter, MDSam F. Carter, MDFrom Murfreesboro Medical Clinic, Murfreesboro, TN 37130.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-11-200812020-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I am puzzled by the recommendation of Phillips and Twombly (1) to change antihypertensive therapy on the basis of single blood pressure measurements and by their dismissal of home monitoring, given the marked variability of blood pressure over time (especially in older patients with systolic hypertension). I have observed fluctuations in systolic blood pressure of up to 100 points over 24 hours in clinically stable patients in both inpatient and outpatient settings. If I have verified in my clinic the reliability of a patient's blood pressure machine, is the average of multiple home measurements not more important ...References1. Phillips LS, Twombly JG. It's time to overcome clinical inertia [Editorial]. Ann Intern Med. 2008;148:783-5. [PMID: 18490691] LinkGoogle Scholar2. Kerr EA, Zikmund-Fisher BJ, Klamerus ML, Subramanian U, Hogan MM, Hofer TP. The role of clinical uncertainty in treatment decisions for diabetic patients with uncontrolled blood pressure. Ann Intern Med. 2008;148:717-27. [PMID: 18490685] LinkGoogle Scholar3. Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D; American Heart Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1-9. [PMID: 18497371] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Murfreesboro Medical Clinic, Murfreesboro, TN 37130.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Role of Clinical Uncertainty in Treatment Decisions for Diabetic Patients with Uncontrolled Blood Pressure Eve A. Kerr , Brian J. Zikmund-Fisher , Mandi L. Klamerus , Usha Subramanian , Mary M. Hogan , and Timothy P. Hofer The Science and Art of Deduction: Complex Systematic Overviews John E. Cornell and Christine Laine Will Running the Numbers First Violate the Principles of Patient-Centered Care? Lawrence S. Phillips and Jennifer G. Twombly Will Running the Numbers First Violate the Principles of Patient-Centered Care? Cynthia M. Boyd and Bruce Leff Will Running the Numbers First Violate the Principles of Patient-Centered Care? Sandeep Vijan , Rodney A. Hayward , and Peter Ubel Will Running the Numbers First Violate the Principles of Patient-Centered Care? Robert C. Sherrick Metrics 2 December 2008Volume 149, Issue 11Page: 840KeywordsAntihypertensive drug therapyBlood pressureConflicts of interestGlucoseHemoglobinHypertensionInpatientsOutpatientsRunningSystolic pressure ePublished: 2 December 2008 Issue Published: 2 December 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...